S286 reports of practical oncology and radiotherapy 1 8 ( 2 0 1 3 ) S282–S288

Incidents control in radiotherapy oncologyM. Enguix Castelo 1, A. Pineiro Redondo 2, V. Munoz Garzón 1, P. Willisch Santamaría 1, M. Martínez Agra 1,J. Vázquez Rodriguez 1, M. Santos Blanco 1, J. Iglesias Rodriguez 1, A. Barciela 3

1 Hospital do Meixoeiro, Servicio de Oncología Radioterápica, Spain2 Hospital do Meixoeiro, Consultoria, Spain3 Hospital do Meixoeiro, Servicio de Oncología Radioterápico, Spain

Introduction. Radiotherapy units are safe departments subjected to protocols and quality management systems. Nevertheless, theexperience shows that equipment failure or human errors still happening. According to data of the IAEA, at least 3000 patientshave been affected by radiotherapy incidents and accidents.Objectives. To investigate the incidents to minimize or avert future treatment errors.Materials and methods. We show the design and implementation of an internal incidence reporting and management system atthe radiotherapy unit of Hospital Meixoeiro. We defined a multidisciplinary team that worked at all the stages of the project. Wedeveloped a supporting documentation form to register type of incidence, causes and people involved to analyze the incidentsreported, designated a system manager and started commissioning to propose solutions and decrease the incidences.Results. At the very beginning the nature of non-conformances reported where organizational. 30.43% of our incidences corre-sponded to failures to start treatment at the right time and soon after we changed our processes, we reduced it to 0%. With thecontinuous improvement of the patient pathway and the involvement of staff in the reporting culture, recent years almost 100%of the statements were about safety concerns, well incidents or near miss. Nowadays we are involved in the evolution of oursystem into a more robust one, which can account for an error coding system and the implementation of lessons learned fromnational and international sources. We observe that there are more incidents because are reported greater number, but havedecrease the repeated incidents.Conclusion. The described experience has been very positive to our organization in terms of safety and staff confidence improve-ment and we highly encourage a pilot-study of a safety reporting and learning system nationally based.

http://dx.doi.org/10.1016/j.rpor.2013.03.358

Influence of techniques in radiotherapy waiting timesJ. Salinas Ramos 1, P. Escolar Perez 1, A. Iglesias Aguera 2, M. Gómez Aparicio 2, E. Martinez Lerma 1

1 Hospital GU Santa Lucia, Cartagena, Oncología Radioterápica, Spain2 Hospital GU Santa Lucia, Oncología Radioterápica, Spain

Introduction. Modern techniques, like IMRT, VMAT, Radiosurgery or SBRT require more time to contouring, planning and qualitycontrol. Waiting times could be outside of standards one. The purpose is to retrospectively measure radiotherapy times indicatorsaccording type of techniques (3D versus others) in a department without LINAC overload.Methods. Reference benchmark/indicators used were: 1. Cancer waiting times (CWT) from UK National Health Services: 31 daysfrom decision to treat to first definitive treatment, expressed as % seen within target recommended wait times (90–100%). 2.Cancer Standards from UK National Health Services: palliative treatment 2–15 days; radical treatment 15–28 days, expressedalso as % seen within target recommended wait times (90–100%). 3. Canadian standards: ready to treat to start of treatment (thetime from when the specialist is confident the patient is ready to begin treatment to the time the patient receives treatment(benchmark 28 days) expressed as median and 90th percentile of number of days waited. Sample includes all consecutive patientstreated with radiotherapy in our department from May 2011 to December 2012, a total of 1151 patients. We have taken into accountplanned wait due to personal, medical and work-related reasons or chemotherapy integration and patient’s related.Results. 1. CWT: results expressed as % of the patients treated within target recommended wait time: Total (1151) 96,4%; 3Dtreatments (523): 98.1%; Other (604): 94.6%. 2. Cancer standards: palliative treatment: total (277) 93.1%; 3D (219) 96.8%, other (58)79.3%. Radical treatment: total (874): 93%; 3D (310): 96,4%; other (564): 92.5%. 3. Canadian standards: median numbers of dayswaited: total: 12; 3D: 4; Other: 13; 90th percentile of number of days waited: total 24; 3D: 14; Other 26.Conclusions. Our results showed that waiting times after modern techniques are longer than 3D but nonetheless we have achieveda high benchmark, except for palliative treatment with modern techniques. Reasons to explain could be low sample number,patient’s related and integration with chemotherapy.

http://dx.doi.org/10.1016/j.rpor.2013.03.359

Organizational guide of a functional head and neck tumour unitJ. Contreras Martínez, A. Slocker Escarpa, I. Fortes de La Torre, M. Hebrero Jiménez, I. Herruzo CabreraComplejo Hospitalario Carlos Haya, Oncología Radioterápica, Spain

Head & neck cancer (HNC) constitutes a high percentage of the cases in the oncology units. The therapeutic progress in HNCcomes from good diagnosis and improvements in surgery, radiotherapy and new pharmacological agents, also because of thereduction of morbidity and mortality thanks to the therapeutic progress and organizational measures. This guide is the resultof the collaboration between different specialists: Oncologists, ORL, CMF, Plastic Surgery, AP, Radiology, Nutrition, Palliative Care